Supporting the premise that rural communities require functioning health care systems for their physiological, emotional, and economic well-being, the First Statewide Legislative Symposium on Rural Development defined problems and established goals for rural health care in New York. Despite increases in New York's overall physician supply during the 1970's, major changes have not occurred in the rural primary care specialties: general and family practice; general internal medicine, surgery and anesthesiology; and general pediatrics. The number of small, rural hospitals of less than 50 beds is dwindling. Increased emphasis on specialty training, rapid growth of medical technology, licensing regulations and practice constraints for health care providers have limited the number and type of personnel that rural hospitals can recruit and retain. The larger proportion of the elderly in rural areas also contributes to the rural health care crisis. State policymakers should develop and implement a flexible planning and regulatory framework that satisfies the health care needs of individual rural communities and improves the supply of health professionals. Public policy should consider how local involvement in the planning, design, implementation, and maintenance of rural health care can be enhanced. The report contains supporting maps, graphs, and charts. (NEC)